Hair pulling: Just another form of self harm? or a disorder in itself?

Ever since I first started read about Trichotillomania, it was always linked back to self harm. It was always explained as ‘more then a bad habit, it’s a form of self harm like cutting’. (Taken from ‘Love saved me from self harm’, Company Magazine, 2003) It is true that pulling your own hair out is an act of harming oneself, but is it really self harm or is it a disorder itself?

Self Harm classifications:

In 1986, Favazza (author of Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry)distinguised self harm into three catorgaries; Major self harm (eg castration, which is rare and seen in psychotic patients mainly), Sterotypical Self Harm (eg head banging seen in autistic children) and Superficial or moderate self harm. This last category includes cutting, burning, skin picking, bone breaking, hitting, small overdoses and pulling your own hair out.

Then in 10 years later in 1996, Favazza breaks down the superficial/moderate self harm into compulsive, eposodic and impulsive self harm. Trichotillomania comes under compulsive. Favazza also states that this type of self harm has different roots (no pun intended there!) to impulisive self injury.
Impulsive self harm is when someone engages in harming themselves, for example cutting, and has difficulty controlling the impulse to cut. They identify themselves as a self harmer whereas eposodic self harmers will self harm now and then and not feel so ‘addicted’.

I am glad there is a distinction between self harm like cutting and the compulsive self harm of hair pulling.

But why am I glad?

Well I have been an impulsive self harmer for many years. Mainly engaging in cutting. Although I hate that word! From my personal experiences, pulling out my hair is totally different to cutting myself.

When I have cut in the past, I feel a build up inside that cannot be relieved in anyway, I need to cut. It is almost a seperate emotion itself. But with hair pulling, yes I get a sort of build up of emotion but the hair pulling is done subconsciously. Cutting is done consciously. When I have cut, it means I have to find my blade, plasters and find a safe place to do it. Hair pulling can happen anywhere at any time and can be infront of people. Because of this, cutting is about 85% behind me whereas hair pulling is very much at the forefront of my mind and causes far more frustration!!!!!!

A tip for self injurers

This is something I learnt to help me at times I want to cut. I imagine a wave. Waves come in and go out, they crash, they fall but nothing is permenant. This is the same as emotion, however bad things are, the wave does go out eventually. This has worked for me.

Responses

This is a really interesting issue. I do not ‘self harm’ but I pull my hair, and I have always thought that the two are not the same (though obviously I have not necessarily experienced this). I definitely think that the subconscious way in which I do it makes it less like self harm. It obviously does harm so it seems like a category like ‘compulsive self harm’ kind of does the job but it’s still one of those really confusing things, for me. Thanks for looking into these questions, I find these posts and the issues that you explore very interesting to read! Such definitions may almost seem pointless to some, but I have come to realise that thinking about them can be really useful.

First of all, let me state that I don’t believe TTM and self-harm or mutilation are anything alike. I pull, but I’ve never been self-harming. I don’t pull with a mission to punish myself, create sores or bleeding, or relieve any emotion. As you stated, I’m often not even aware of it.

TLC’s stance is this: “People with TTM are not trying to injure themselves or to purposefully damage their appearance. Though hard to understand, the hair pulling often feels pleasurable rather than painful. People with TTM are not necessarily particularly anxious or troubled (except by hair pulling): in fact, they are often very successful human beings.

i’ve been hair pulling to the point of almost being bald.. i dont do it to hurt myself, i dont even know im doing it half the time.. only when i can feel the hairs tickling my arms..its actually really getting to me and taking over my life.. are there any tips on how to stop??

I’m a 57 year old grandma and I started pulling my hair at age 16. Over the last 40+ years I’ve gone from tiny bald spots to completly bald wearing a wig. At this point in my life I have VERY thin hair and some bald spots. At 20 years old I would wonder, “Will I be doing this at 30″? Nobody seems to understand it or how to controll it. It has always controlled me, as much as I hate it!

Leah…
I dont know if you will ever read this because your comment was posted a cople years ago…
I have pulled my hair since I was four or five and I am now 21. I have thought of myself in the future and wondered if I would still be doing this.. barely any eyebrows, no eyelashes and rationing my pulling to certain places so I dont get any balled spots on my head.. and here I am still trying.
It is very frustrating, and sometimes.. when I try too hard to suppress the urge to pull, my body physically must have some other kind of outlet and I scratch my arms or legs or create some kind of pain so I can resist pulling. Is this familiar to anyone else???
I was searching trich and this site came up.. Only reason I am responding is because we have the same name and because I hope you are still out there.. Hopefully you have worked through it and it no longer controls you as it still does me…
Best wishes
Lia

I suffered from hair pulling when I was about 13 and continued until I was 45, I didn’t find out the technical term of TTM until about ten years ago. I was pleased to know it was a condition. Five years ago I plucked up the courage to visit a cognitive therapist for approx. 10 sessions at £50 each. I’m pleased to say I have not pulled my hair out since. I urge you to have a go despite the expense, the alternative is to be bald or buy a wig.

Hello. I found out two years ago that hair pulling was a form of self mutilation. For a while I played it off like I didn’t believe it, but really I knew it was true. I have been pulling my hair out for longer then I can remember, at least since I was 13. I am almost 21. I used to know when I was doing it and did it for the feeling. I would agree that it’s not really “painful” however, that might be just because its a release and I see it as a comfort. Now, I don’t know it’s happening. I’ll be watching a movie, doing homework, or other activities and I feel the pull. That’s when I know it happened. I have many balding spots and such so started pulling different places.
I wanted to post because my life has gotten really out of control and not the pulling isn’t enough, I have been fighting the desire to cut/scratch for a few weeks. If you are pulling, get help. It CAN lead to more. It makes you feel lost in it, and there’s nothing worse then knowing you don’t even have control. Thank you for this site, it was really helpful.

Hi, i have been pulling since the young age of about 5, i am now 25 and i still pull as bad as ever. ant stop. Its so hard. I’ve never had the urge to cut thank god, but hair pulling iis so Depressing. What is it that makes us pull? I find it so confusing???

Iv been pulling my eyebrows out since I was about 16. I am now 21. I now have none at all and whenever I feel 1 grow back I have to pull it out, I just can’t help it, now that I have no eyesbrows to pull out iv started on the hair on my head, iv only been doing it for a few months but already have bald patches, I need to stop!! Someone please help me!!

I pull my hair and pick at my skin out of both compulsion and impulsive self-harm. As you’ve mentioned, the thought processes aren’t the same, where one feels like an itch while another is with full intent and disregard for the consequences. It’s easy to differentiate between the two mindsets when I’m not being overwhelmed by stress and emotions, but when I feel a strong urge to pull/pick, I usually don’t question my motive before my hand reaches the top of my head.